VINA DEL MAR ASSISTED LIVING AND MEMORY CARE

Official classification

Type B

Official code

87211(a)(1)

Regulation authority

CCR

What the official deficiency says

87211 Reporting Requirements: (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: (1) A written report shall be submitted to the licensing agency & to the person responsible for the resident within 7 days of the occurrence of any of the events specified in (A) through (D) below: This requirement has not been met as evidence by: Based on interview & records review the facility failed to submit written incident report to licensing agency for resident (R1) after noticing skin discoloration on their left eye, which possess potential health, safety, personal rights risk to clients in care.

Official plan of correction

Facility to submit a plan of how facility will ensure future compliance regarding required written reports by POC date to clear the citation.

Deadline recorded: Dec 24, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87463

Regulation authority

CCR

What the official deficiency says

87463 Reappraisals (c) The licensee shall arrange a meeting with the resident, the resident’s representative, if any, appropriate facility staff…when there is significant change in the resident’s condition…This requirement has not been met as evidence by: Based on records review, the facility did not notify resident’s (R1) responsible party about R1’s change of condition, which possess potential health, safety, personal rights risk to clients in care.

Official plan of correction

Facility to submit a plan of how facility will ensure future compliance regarding notifying resident's responsible parties after a change of condition is noticed by POC due date to clear the deficiency.

Deadline recorded: Dec 24, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87303(e)(2)

Regulation authority

CCR

What the official deficiency says

(e) Water supplies and plumbing fixtures shall be maintained as follows: (2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degrees C) and not more than 120 degree F (49 degrees C). This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's/Director observation, interview and record review, the licensee did not comply with the section cited above in two out of eight faucets used by residents in care that measured less than 105 degree F, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/31/2024 Plan of Correction The Director agrees to adjust water heater temperature, start a log of water temperature for seven days, then the facility will send to CCL with form LIC9098 by POC due date to clear deficiency.

Official classification

Type B

Official code

1569.618(c)(3)

Regulation authority

HSC

What the official deficiency says

(c)The facility shall employ, and the administrator shall schedule, a sufficient number of staff members to do all of the following: (3) Ensure that at least one staff member who has cardiopulmonary resuscitation (CPR) training and first aid training is on duty and on the premises at all times. This paragraph shall not be construed to require staff to provide CPR. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's/Director observation, interview and record review, the licensee did not comply with the section cited above in four out of four staff have not completed CPR training, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/31/2024 Plan of Correction The Director agrees to have staff complete CPR/1st aid training and send to CCL with form LIC9098 by POC due date to clear deficiency.

Official classification

Type B

Official code

1569.625(b)(2)

Regulation authority

HSC

What the official deficiency says

(2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696. This training shall be administered on the job, or in a classroom setting, or both, and may include online training. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's/Licensee observation, interview and record review, the licensee did not comply with the section cited above in four out of four staff do not have additional training 20 hours completed, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/31/2024 Plan of Correction The Director agrees to have staff complete training and send to CCL with form LIC9098 by POC due date to clear deficiency.

Official classification

Type B

Official code

87705(c)(6)

Regulation authority

CCR

What the official deficiency says

(c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (6) Appraisals are conducted on an ongoing basis pursuant to Section 87463, Reappraisals. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's/Director observation, interview and record review, the licensee did not comply with the section cited above in two out of two residents who did not have their care plan updated which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/31/2024 Plan of Correction The Director agrees to have complete care plans for residents and send to CCL with form LIC9098 by POC due date to clear deficiency.

Official classification

Type A

Official code

87705(b)(2)

Regulation authority

CCR

What the official deficiency says

87705(b)(2) Care of Persons with Dementia. … Safety measures to address behaviors such as wandering, aggressive behavior and ingestion of toxic materials. ***Based upon review of documents, this requirement not met as evidenced by: On 4/11/2022, R1 wandered off facility property alone until returned an hour later. This posed an immediate risk to safety of R1.

Official plan of correction

Cleared at time of visit. This issue was addressed on 7/14/2022 on a case management basis when it was determined that facility had modified fencing in response to the elopement.

Deadline recorded: Feb 28, 2024. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

1569.269(a)(16)

Regulation authority

HSC

What the official deficiency says

1569.269(a)(16) Enumerated Rights. To reasonable accommodation of individual needs and preferences in all aspects of life in the facility, except when the health or safety of the individual or other residents would be endangered.*** Based on statements, this requirement not met as evidenced by: R1’s visitors were told by staff not to bring outside food to R1 at the facility. This posed an immediate violation of R1’s enumerated rights.

Official plan of correction

Administration will review 1569.269 and will submit a declaration of completion to CCL by POC date in order to clear the deficiency.

Deadline recorded: Mar 1, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87463(c)

Regulation authority

CCR

What the official deficiency says

(c) The licensee shall arrange a meeting with the resident, the resident's representative, if any, appropriate facility staff, and a representative of the resident's home health agency, if any, when there is significant change in the resident's condition, or once every 12 months, whichever occurs first, as specified in Section 87467, Resident Participation in Decision Making. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in 4 of 6 records. Appraisals were not updated at least every 12 months, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/02/2024 Plan of Correction Licensee to submit written plan outlining how facility will ensure appraisals are updated as needed or at least every 12 months. Written plan to be submitted to CCL by POC date of 02/02/2024.